摘要
目的观察不同剂量恩替卡韦(ETV)联合阿德福韦酯(ADV)治疗拉米夫定(LAM)耐药慢性乙型肝炎患者(CHB)的临床疗效和安全性。方法将161例LAM耐药CHB患者随机分成3组:对照组53例应用LAM联合ADV挽救治疗,观察1组56例应用0.5 mg ETV联合ADV治疗,观察2组52例应用1.0 mg ETV联合ADV治疗。观察治疗前及治疗12、24、48周后3组患者血清肝功能指标(ALT和AST)、HBe Ag和HBV DNA水平的变化。结果治疗后12、24、48周,两个观察组ALT和AST改善情况明显优于对照组(P<0.05);两个观察组HBe Ag阳性患者阴转率与对照组比较无统计学意义;两个观察组HBV DNA转阴(低于检测下限)率与对照组比较,具有统计学意义(P<0.05)。两个观察组之间比较,治疗12、24、48周后ALT和AST、HBe Ag阳性患者阴转率和HBV DNA转阴率均无显著性差异。结论 0.5 mg ETV联合ADV治疗LAM耐药的CHB患者的疗效确切而且能够减轻患者经济负担。
Objective To investigate the efficacy and safety of the combined therapy with different doses of entecavir（ETV） and adefovir dipivoxil （ADV） in patients with lamivudine （LAM）-resistant chronic hepatitis B （CHB）.Methods A total of 161 patients with LAM-resistant CHB were randomly divided into three groups.The control group（n =53）patients received the combined therapy with LAM and ADV.The observation group 1（n =56） patients received the combined therapy with 0.5mg ETV and ADV.The observation group 2（n =52） patients received the combined therapy with 1.0mg ETV and ADV.The changes in levels of alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,HBeAg and HBV DNA before and after 12,24,and 48 weeks of treatment,were measured in the three groups.Results The levels of ALT and AST in the two observa-tion groups were significantly lower than those in the control group after 12, 24, and 48 weeks of treatment（P 〈0.05）.There was no significant difference in the HBeAg seroconversion rate among HBeAg-positive patients between the control group and the two observation groups.The serum HBV DNA clearance rates in the two observation groups after 12,24,and 48 weeks of treatment were significantly higher than those in the control group（P 〈0.05）.There was no significant difference in the levels of ALT,AST,HBeAg seroconversion rate and HBV DNA clearance rates between the two observation groups.Conclusion The combined therapy with 0.5mg ETV and ADV has good therapeutic effect in treating LAM-resistant CHB patients in addition to the advantage of lightening the economic burden on patients.Its clinical application is highly recommended.
出处
《淮海医药》
CAS
2015年第5期435-437,共3页
Journal of Huaihai Medicine
